Healthcare Provider Details
I. General information
NPI: 1073398103
Provider Name (Legal Business Name): INHOUSE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2023
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
137 MOUNTAIN AVE
HACKETTSTOWN NJ
07840-2390
US
IV. Provider business mailing address
137 MOUNTAIN AVE
HACKETTSTOWN NJ
07840-2390
US
V. Phone/Fax
- Phone: 908-852-1887
- Fax: 908-852-0614
- Phone: 908-852-1887
- Fax: 908-852-0614
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VINEET
SANDHU
Title or Position: OWNER
Credential: MD
Phone: 908-852-1887